Ward C F, Ward G C, Saidman L J
JAMA. 1983 Aug 19;250(7):922-5.
Experience at our institution with drug dependence among anesthesia residents, coupled with a lack of published data, prompted us to survey US anesthesia training programs. Two hundred eighty-nine programs were surveyed, 247 (85.5%) responded, and 184 (74%) of these programs had at least one suspected incident of drug dependence to report. Three hundred thirty-four confirmed persons were reported, including a substantial number of instructors. Meperidine and fentanyl were the most frequently mentioned drugs. Behavior changes were frequently noted by staff personnel, and in general such changes led directly to detection. After confirmation of abuse, the majority of impaired anesthetists were referred for psychiatric care, with few in need of actual detoxification. Detailed follow-up was available for about 40% of the total; 71 persons were offered a return to their original place of employment, while 30 persons died of drug overdose. Chemical impairment may be more common than usually thought in anesthesia, perhaps in part because of drug availability.
我们机构在麻醉住院医师药物依赖方面的经验,再加上缺乏已发表的数据,促使我们对美国的麻醉培训项目进行调查。我们调查了289个项目,247个(85.5%)做出了回应,其中184个(74%)项目至少有一起疑似药物依赖事件需要报告。共报告了334名确诊人员,其中包括相当数量的教员。哌替啶和芬太尼是最常被提及的药物。工作人员经常注意到行为变化,一般来说,这些变化直接导致了药物依赖的发现。在确认滥用药物后,大多数麻醉师功能受损的人被转介接受精神科治疗,很少有人需要实际的戒毒治疗。约40%的人有详细的后续情况;71人被提供回到原工作岗位,而30人死于药物过量。化学物质导致的功能受损在麻醉领域可能比通常认为的更为常见,部分原因可能是药物容易获取。